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腹部大手术期间的意外围手术期低体温及重要危险因素

Inadvertent Perioperative Hypothermia and Important Risk Factors during Major Abdominal Surgeries.

作者信息

Sagiroglu Gonul, Ozturk Gozde Argunsah, Baysal Ayse, Turan Fatma Nesrin

机构信息

Department of Anesthesiology, Faculty of Medicine, Trakya University, Edirne, Turkey.

Department of Anesthesiology, Pendik Bolge Hospital, Pendik, Istanbul, Turkey.

出版信息

J Coll Physicians Surg Pak. 2020 Feb;30(2):123-128. doi: 10.29271/jcpsp.2020.02.123.

Abstract

OBJECTIVE

A relation between inadvertent perioperative hypothermia and possible important risk factors during major abdominal surgeries was investigated.

STUDY DESIGN

Cross-sectional descriptive study.

PLACE AND DURATION OF STUDY

Trakya University Hospital, Edirne, Turkey during 2016-2018.

METHODOLOGY

Five hundred and twenty-nine patients undergoing major abdominal surgey were divided into two groups depending on postoperative body core temperature (CTM) by the use of tympanic membrane measurement. Patients with a temperature of less than 36oC indicated hypothermia group; whereas, patients with a temperature between 36 and 37.5oC indicated normothermia group. The parameters that were considered as risk factors for hypothermia include; baseline characteristics, American Society of Anesthesiologists (ASA) status, comorbidities, operative type, duration of surgery, patient and operative room temperatures, intraoperative hemodynamic parameters, transfusion of fluids and packed red blood cells (PRBCs), labaratory data, and adverse events. Correlation between these parameters and inadvertent hypothermia was sought. A p-value of less than 0.05 was considered statistically significant.

RESULTS

The risk factors that showed a correlation with hypothermia include: male gender, advanced age, high ASA scores, smoking, prolonged duration of operation, transfusion of fluids and PRBCs (p<0.05). In hypothermia group, duration of operation time was longer, need for transfusion was greater, hematocrit and hemoglobin values were lower than Normothermia Group of patients (p<0.05). Hypothermia was detected in 335 (63.3%) of patients.

CONCLUSION

In this study, important risk factors for inadvertent hypothermia were found as; male gender, advanced age, high ASA scores, smoking, prolonged duration of operation, transfusion of fluids and/or PRBCs.

摘要

目的

研究腹部大手术期间意外围手术期低温与可能的重要危险因素之间的关系。

研究设计

横断面描述性研究。

研究地点和时间

2016年至2018年期间,土耳其埃迪尔内的特拉凯亚大学医院。

方法

采用鼓膜测量法,根据术后体核温度(CTM)将529例行腹部大手术的患者分为两组。体温低于36℃的患者为低温组;体温在36至37.5℃之间的患者为正常体温组。被视为低温危险因素的参数包括:基线特征、美国麻醉医师协会(ASA)分级、合并症、手术类型、手术持续时间、患者和手术室温度、术中血流动力学参数、液体和浓缩红细胞(PRBC)输注、实验室数据以及不良事件。寻找这些参数与意外低温之间的相关性。p值小于0.05被认为具有统计学意义。

结果

与低温相关的危险因素包括:男性、高龄、ASA评分高、吸烟、手术时间延长、液体和PRBC输注(p<0.05)。低温组的手术时间更长,输血需求更大,血细胞比容和血红蛋白值低于正常体温组患者(p<0.05)。335例(63.3%)患者检测到低温。

结论

在本研究中,发现意外低温的重要危险因素为:男性、高龄、ASA评分高、吸烟、手术时间延长、液体和/或PRBC输注。

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